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ForumsPublic SquareHELP - accidentally left my vial out overnight — 6 month update

HELP - accidentally left my vial out overnight — 6 month update

SleepDoc_PDX Sat, Oct 19, 2024 at 3:16 AM 29 replies 2,242 viewsPage 1 of 6
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SleepDoc_PDX
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Oct 19, 2024 at 3:16 AM#1

Posting this because the summary going around does not say what the paper says, and the difference matters for how people here are using it.

Read four things before the headline number. The population, because trial populations are selected and supported in ways that real cohorts are not. The comparator, because "better than placebo" and "better than the current standard" are different claims and get reported identically. The primary endpoint as pre-registered, because a secondary endpoint promoted after the fact is a hypothesis rather than a finding. And the completion rate, because a large effect in the half of participants who finished is a different result from a large effect in everybody enrolled.

Where I think it is weakest: the follow-up is short relative to how long people actually take these drugs, so durability is an assumption here rather than a finding.

The narrow version of the question is how to read a result like this without either dismissing it or over-reading it, since the summaries all read like press releases. I have searched first, so if this is covered somewhere point me at it and I will read it.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
47 0pete_nash, hank_denver, carlos_SATX and 44 others
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PharmD_Rodriguez
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Oct 19, 2024 at 3:29 AM#2
SleepDoc_PDX said:
Read four things before the headline number.

No disagreement with SleepDoc_PDX. One condition attached. Relative and absolute effects need reading together. A 20% relative reduction on a high baseline risk is a large absolute benefit; the same relative figure on a low baseline risk is a small one, and press summaries almost always quote the relative number because it is bigger.

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DataDave
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Oct 19, 2024 at 3:42 AM#3
SleepDoc_PDX said:
Read four things before the headline number.

I read this differently from SleepDoc_PDX, on substance rather than tone. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

That is the short version; the long version is somebody else's post.

Last edited: Oct 19, 2024 at 4:42 AM
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Dr.SleepRoch
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Oct 19, 2024 at 3:55 AM#4

Answering the narrow version, because the broad one does not have a single answer. The gap between trial results and real-world results is consistent and it is not fraud. Trial participants get titration by protocol, scheduled contact, free drug and dietetic support; removing that infrastructure costs a few percentage points every time it has been measured. When your own curve sits below the published mean, that is the likeliest explanation before anything about you or your material.

50 3tony_orlando, Dr.NephBHM_UK, kim_atl_prep and 47 others
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SleepFixSam
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Oct 19, 2024 at 5:03 AM#5
PharmD_Rodriguez said:
Relative and absolute effects need reading together.

Adding a me-too, because a thread of one person's experience is not much use. Nothing to add that would improve it.

Last edited: Oct 19, 2024 at 7:03 AM
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